Mara D. Mamroud, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

019065 Issued in NY

Practice address

15 West 65TH St
2ND Floor
New York, NY 10023

Phone

(212) 787-5400

NPI assigned

Jun 15, 2009

Last updated

Nov 19, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mara D. Cole Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1205063419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 ADAMS ST",
            "address_2": "APT 611",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "07030",
            "telephone_number": "516-457-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 WEST 65TH ST",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10023",
            "telephone_number": "212-787-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMROUD",
        "first_name": "MARA",
        "middle_name": "D.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03709579",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARA",
            "last_name": "COLE",
            "middle_name": "D.",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anzhella Mamonov, R.N
• Sadaaf Nabeel Mamoon, MHC-LP
• Jenna Mamorsky
• Marta M Mamos, PT
• Susan Meroy Mamot, DMD
• Anita Mamtani, M.D.
• Hafsa Mamun
• Rusudan Mamutchadze, M.D.
• Man S. Kim Physical Therapy P.C.
• Dennis Man, RPH

• Speech-Language Pathologist in New York, NY
• Providers in New York, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.